Perceptions of the policing and crime mapping ‘Trailblazers’, Home Office Research Report 67

The research involved interviews with key staff involved and focus groups with members of the public to explore their views and opinions on the initiatives. The research highlights considerable public curiosity, and to an extent an appetite, for crime and criminal justice information. However a key message from the research was that providing more information should not be an end in itself. Information needs to be relevant, useable, of high quality and tailored to suit its purpose, whether that is crime prevention or holding the police to account

Flexible New Deal evaluation: customer survey and qualitative research findings

by Sandra Vegeris, Lorna Adams, Katie Oldfield, Christine Bertram, Rosemary Davidson, Lucia Durante, Catherine Riley and Kim Vowden This report presents qualitative and quantitative research findings from an evaluation of the Flexible New Deal (FND), Phase 1 of which was introduced in October 2009 in 28 Jobcentre Plus districts in England, Scotland and Wales. The research consisted of qualitative research into customer and provider experiences of FND delivery and a quantitative survey of customer experiences of FND in Phase 1 areas compared with customers at the same point in their claims experiencing the former Jobseeker’s Allowance (JSA) regime and New Deals in Phase 2 areas. Comparisons between the two areas provide an indication of FND services in contrast to JSA/New Deal services but they do not constitute an impact assessment. This is the fourth in a series of evaluation reports aiming to understand experiences of the Jobseekers Regime and Flexible New Deal (JRFND) from the point of view of customers, Jobcentre Plus staff and provider staff, and establish the extent to which JRFND leads to additional customer employment outcomes

Jobseekers Regime and Flexible New Deal, the Six Month Offer and Support for the Newly Unemployed evaluations: An early process study

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Autolysis: mechanisms of action in the removal of devitalised tissue

Chronic wounds affect millions of people worldwide. In the UK alone, the cost of their treatment is estimated to be between £4.5bn and £5.1bn. The implementation of wound-bed preparation strategies remove the barriers to healing and wound debridement is a key component in preparing the wound bed for wound progression. This article aims to review one of the several debridement methods available to clinicians: autolytic debridement. Autolysis (i.e. autolytic debridement) uses the body's own enzymatic mechanisms to remove devitalised tissue in order to remove the barriers to healing. This review aims to provide clinicians working in wound care with a better understanding of the mechanisms and implications of autolytic debridement

Approach to a rational rotation number in a piecewise isometric system

We study a parametric family of piecewise rotations of the torus, in the limit in which the rotation number approaches the rational value 1/4. There is a region of positive measure where the discontinuity set becomes dense in the limit; we prove that in this region the area occupied by stable periodic orbits remains positive. The main device is the construction of an induced map on a domain with vanishing measure; this map is the product of two involutions, and each involution preserves all its atoms. Dynamically, the composition of these involutions represents linking together two sector maps; this dynamical system features an orderly array of stable periodic orbits having a smooth parameter dependence, plus irregular contributions which become negligible in the limit.Comment: LaTeX, 57 pages with 13 figure

The Role of Resilience in Rebuilding Lives of Injured Veterans

The aim of this commentary is to discuss potential clinical implications of introducing resilience building interventions into care for veterans who are living with a war wound. Some war veterans are expected to live with a wound upon discharge from an active military role and also to fit into civilian life. These lifestyle adjustments can tax the person’s coping abilities and in that context may hinder successful adaptation. The experience of living with a wound or wounds, either acute or chronic, is connected to losses, including loss of mobility, loss of financial capacity (unable to work during some of the wound healing period) and losses attached to changed social roles. Psychological stress is also a common experience for veterans returning to civilian life. Psychological stress is associated with impaired healing or dysregulation of a biomarker associated with wound healing. Modern health practice is centred on symptom reduction and working with pathology however, working with people’s adaptive behaviours such as resilience has not been a consideration. Using the resilience model as a conceptual framework healthcare professionals can engage with veterans towards resilience within the context of their personal experience of ill health. Using this contemporary framework for considering these aspects of care has the potential to facilitate resistance to stressors associated with being injured potentially averting quality of life impairments

Wound bed preparation: A novel approach using HydroTherapy

Wounds that fail to heal quickly are often encountered by community nursing staff. An important step in assisting these chronic or stalled wounds progress through healing is debridement to remove devitalised tissue, including slough and eschar, that can prevent the wound from healing. A unique wound treatment called HydroTherapy aims to provide an optimal healing environment. The first step of HydroTherapy involves HydroClean plus™, this dressing enables removal of devitalised tissue through autolytic debridement and absorption of wound fluid. Irrigation and cleansing provided by Ringer’s solution from the dressing further removes any necrotic tissue or eschar. Once effective wound bed preparation has been achieved a second dressing, HydroTac™, provides an ongoing hydrated wound environment that enables re-epithelialisation to occur in an unrestricted fashion. This paper presents 3 case studies of slow healing wounds treated with HydroClean plus™ which demonstrates effective wound debridement

A cost-effectiveness analysis of a hydration response technology dressing in the treatment of venous leg ulcers in the UK

Introduction: Venous leg ulceration causes significant pain and suffering for patients, additionally it places considerable financial and service burden on the National Health Service (NHS). A large proportion of venous leg ulceration do not heal within the standard time frames of 16 – 24 weeks, resulting in static wounds which commonly have issues with increasing exudate production. Static wounds can have significant negative impact on the patients quality of life, the wound bed and periwound skin, increased risk of infection all of which results in delayed wound healing and increased health service costs. As the NHS continues to face times of austerity, services need to find solutions to be able to reduce cost and release nursing time whilst maintaining standards of care. Cutimed® Sorbion® Sachet S is a treatment option for the management of patients with a venous leg ulceration. The objective of this study was to provide an update of the health economic analysis of Cutimed® Sorbion® Sachet S in comparison to relevant comparators in the UK with current cost data. Methods: Cutimed® Sorbion® Sachet S was compared against Zetuvit Plus, DryMax extra, KerraMax Care and Eclypse from a cost effectiveness perspective. Clinical data were derived from literature and expert opinion. Cost input was utilized based on publicly available data and literature. The average patient in the model is assumed to be 65 years with a diagnosed venous leg ulcer. It is assumed that patients in the different treatment arms have the same background mortality, hence the endpoint mortality is not included in the model. The analysis is based on a deterministic Markov model derived from Harding et al. with weekly cycles. The following assumptions are made: First, all patients start in a static health state with a non-healed but non-progressing venous leg ulcer. It is assumed in the model that patients can transition to a deteriorating health state where a wound is improving or the wound could progress. Additionally, venous leg ulcers could be healed from a progressed wound (i.e. improved wound), they could develop into a severe wound with complications (infections) to be treated in hospitals. The time frame for the analysis was fixed for one year and no re-occurence after healing was assumed to happen. Results: The cost-effectiveness analysis demonstrates health economic dominance of Cutimed® Sorbion® Sachet S being more effective and cost-saving against all analysed comparators. When using literature-based input values the incrementally higher healing rates for Cutimed® Sorbion® Sachet S are 11.04 months (versus Zetuvit Plus), 29.04 months (versus DryMax extra), 1.68 months (versus KerraMax Care) and 11.04 months (versus Eclypse). Cost savings per patient were 37.60£ (versus Zetuvit Plus), 171.68£ (versus DryMax extra), 3.13£ (versus KerraMax Care) and 43.63£ (versus Eclypse). Clinical benefits and cost savings are increasing when real life practice assumptions based on expert opinion are included. Conclusions: Based on the underlying health economic model, Cutimed® Sorbion® Sachet S is more effective and less costly than other comparative products in venous leg ulcers in the UK